Saturday, September 22, 2001

Prompt counseling would have helped hemophiliacs

By Joe Humphreys from the Irish Times on the Web


Early counseling of hemophiliacs diagnosed with HIV and hepatitis C could have limited the psychological damage resulting from their infection, the Lindsay tribunal heard yesterday.

Ms Jo Campion, a Dublin-based psychologist who provided counseling to infected hemophiliacs, said she was struck by how many of them persisted in a state of denial and depression.

A "significant number" of her hemophilia clients, she said, suffered clinical depression, which was "well established" and very difficult to treat, requiring a combination of antidepressant medication and psychotherapy.

A significant number also abused alcohol as a means of managing their HIV, she said.

A smaller number engaged in "passive self harm", whereby they delayed treating bleeds which resulted from their condition. Others had contemplated suicide.

She stressed that by anticipating the response to trauma, and intervening at an early stage, one could very often avoid a patient falling into clinical depression.

The tribunal has heard contradictory evidence about the provision of counseling to hemophiliacs in the early stages of their diagnoses.

Many victims and their families claimed they never received counseling. But hospitals said it was available to a limited extent but was not taken up.

Ms Campion, who since 1996 has been employed by health boards to provide counseling to people with hepatitis C, including hemophiliacs and women infected through Anti-D, said she could not speak for other practitioners but she had seen "a good uptake". In the period 1996-99, she counseled 600 people.

She noted those who were originally diagnosed with HIV in the mid-1980s were "the worst possible candidates psychologically to cope with the new diagnosis of hepatitis C".

The double blow led to a mistrust of the medical profession which persisted into later life, she said.

Asked how novel the concept of trauma counseling was in the mid-1980s, Mr. Campion replied that she had been involved in crisis intervention from as early as 1978 when she worked with mothers of children with spina bifida in a clinic in Cork. She recalled that she was invited to meet mothers before birth to establish a relationship as part of an anticipatory response.

Hemophiliacs have complained that the only form of counseling they were given was by way of a brief consultation by a treating doctor after diagnosis. In St James's Hospital, Dublin, test results were often given in a corridor.

Ms Campion said it was essential patients were afforded privacy and adequate time to assimilate traumatic news in the initial contact. She added the initial contact was very important in determining whether people were likely to take up counseling.